Date:  16 April 1949
Cert:  10112 
Place of Death: County: Knott      City or Town: Lackey
Length of stay (in this place): 01 day
Name of Hospital or Institution: Stumbo Mem. Hosp.
Usual Residence of Deceased: State: Ky.     County:  Knott
City or Town:  Dema     Street Address: (blank)
Full Name:  Tipton C. COLLINS
Date of Death:  16 April 1949
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth:  08 July 1895
Age:  53 years
Usual Occupation: Miner
Kind of Industry or business: Coal
Birthplace:  Raven, Ky.
Father's Name:  John COLLINS
Mother's Maiden Name:  Ellen SLONE
Was deceased ever in armed forces: Yes, World War I, 1917-1918
Social Security No.: 400-05-4309
Informant:  Mary COLLINS
Disease/condition directly leading to death: Cerebral Hemorrhage
Interval between onset and death:  (blank)
Due to:  Gunshot wound of head
Other significant conditions: (blank)
Date of Operation: (blank)
Major findings of operation: (blank)
Autopsy:  No
Accident, suicide, or homicide: Suicide
Place of injury:  Home
City or Town, County, State: Dema, Knott, Ky.
Time of Injury: 15 April 1949
Injury occurred at work:  Not while at work
How did injury occur:  Man shot self with Revolver
I hereby certify that I attended deceased from 15 April 1949 to 16 April 1949, that I last saw the deceased alive on 16 April 1949, and that death occurred at 1:00 a.m., from the causes and on the date stated above.
Date signed:  03 May 1949
Address:  Lackey, Ky.
Signature:  Robert D. Eastridge, M.D.
Burial, Cremation or Removal:  Burial
Date:  17 April 1949
Name of Cemetery or Crematory:  Turner Cemetery
Location:  Dema, Ky.
Date received by local registrar:  03 May 1949
Registrar's Signature:  Rose B. Craft
Funeral director & address:  W. J. Ryan, Martin, KY
Transcribed by Debbie Tamborski, 03 January 2011